What is the most important information I should know about carbamazepine? Back to top

You should not take carbamazepine if you have a history of bone marrow suppression, if you are also taking nefazodone, or if you are allergic to an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), desipramine (Norpramin), imipramine (Tofranil), or nortriptyline (Pamelor).

This medication may cause severe or life-threatening skin rash. Your doctor may recommend a blood test before you start the medication to determine your risk.

Do not start or stop taking carbamazepine during pregnancy without your doctor's advice. Carbamazepine may cause harm to an unborn baby, but having a seizure during pregnancy could harm both the mother and the baby. Tell your doctor right away if you become pregnant while taking carbamazepine for seizures.

TELL YOUR DOCTOR ABOUT ALL OTHER MEDICINES YOU USE. Some drugs can raise or lower your blood levels of carbamazepine, which may cause side effects or make carbamazepine less effective. Carbamazepine can also affect blood levels of certain other drugs, making them less effective or increasing side effects.

What is carbamazepine? Back to top

Carbamazepine is an anticonvulsant. It works by decreasing nerve impulses that cause seizures and pain.

Carbamazepine is used to treat seizures and nerve pain such as trigeminal neuralgia and diabetic neuropathy. Carbamazepine is also used to treat bipolar disorder.

Carbamazepine may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking carbamazepine? Back to top

Do not use carbamazepine if you also take nefazodone, or if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days.

You should not take carbamazepine if you have a history of bone marrow suppression, or if you are allergic to carbamazepine or to an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), desipramine (Norpramin), doxepin (Sinequan, Silenor), imipramine (Tofranil), or nortriptyline (Pamelor).

Carbamazepine may cause severe or life-threatening skin rash, and especially in people of Asian ancestry. Your doctor may recommend a blood test before you start the medication to determine your risk.

To make sure carbamazepine is safe for you, tell your doctor if you have any of these conditions:

• heart disease, high blood pressure, high cholesterol or triglycerides;
• liver or kidney disease;
• glaucoma;
• a thyroid disorder;
• lupus;
• porphyria; or
• a history of mental illness, psychosis, or suicidal thoughts or actions.

You may have thoughts about suicide while taking carbamazepine. Tell your doctor if you have symptoms of depression or suicidal thoughts. Your family or other caregivers should also be alert to changes in your mood or symptoms.

FDA pregnancy category D. If you are pregnant, DO NOT START TAKING carbamazepine unless your doctor tells you to. Carbamazepine may cause harm to an unborn baby, but having a seizure during pregnancy could harm both the mother and the baby. If you become pregnant while taking carbamazepine, DO NOT STOP TAKING the medicine unless your doctor tells you to.

Do not start or stop taking carbamazepine during pregnancy without your doctor's advice.

Carbamazepine can make birth control pills or implants less effective. Use a barrier form of birth control (such as a condom or diaphragm with spermicide) to prevent pregnancy while taking carbamazepine.

Carbamazepine can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using carbamazepine.

How should I take carbamazepine? Back to top

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results.

Do not crush, chew, break, or open an extended-release tablet or capsule. Swallow the pill whole. Breaking the pill would cause too much of the drug to be released at one time.

You may open the extended-release capsule and sprinkle the medicine into a spoonful of pudding or applesauce to make swallowing easier. Swallow right away without chewing. Do not save the mixture for later use. Discard the empty capsule.

Shake the oral suspension (liquid) well just before you measure a dose. Measure the liquid with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

The chewable tablet must be chewed before you swallow it.

It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and call your doctor promptly if this medicine seems to stop working as well in preventing your seizures.

While using carbamazepine, you may need frequent blood tests at your doctor's office.

Do not stop using carbamazepine without first talking to your doctor, even if you feel fine. You may have increased seizures or unpleasant withdrawal symptoms if you stop using carbamazepine suddenly.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose? Back to top

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose? Back to top

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include shallow breathing, urinating less or not at all, muscle twitcing, tremors, slurred speech, or staggering walk.

What should I avoid while taking carbamazepine? Back to top

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Drinking alcohol can increase some of the side effects of carbamazepine, and can also increase your risk of seizures.

Avoid exposure to sunlight or tanning beds. Carbamazepine can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Grapefruit and grapefruit juice may interact with carbamazepine and lead to unwanted side effects. Discuss the use of grapefruit products with your doctor.

What are the possible side effects of carbamazepine? Back to top

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: sudden mood or behavior changes, depression, anxiety, insomnia, or if you feel agitated, hostile, restless, irritable, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have a serious side effect such as:

• fever, tired feeling, weakness, confusion, pale skin, feeling light-headed or short of breath;
• feeling like you might pass out;
• easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;
• slow, fast, or pounding heartbeats;
• nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
• urinating less than usual or nor at all;
• confusion, agitation, vision problems, hallucinations;
• swelling, rapid weight gain; or
• severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Less serious side effects may include:

• dizziness, drowsiness,
• nausea, vomiting, feeling unsteady;
• dry mouth, swollen tongue; or
• loss of balance or coordination.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect carbamazepine? Back to top

Sometimes it is not safe to use certain medications at the same time. Some drugs can raise or lower your blood levels of carbamazepine, which may cause side effects or make carbamazepine less effective. Carbamazepine can also affect blood levels of certain other drugs, making them less effective or increasing side effects.

Cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for anxiety can add to sleepiness caused by carbamazepine.

Many drugs can interact with carbamazine, and not all are included in this medication guide. TELL YOUR DOCTOR ABOUT ALL OTHER MEDICINES YOU USE, especially:

• theophylline (Aquaphyllin, Asmalix, Elixophyllin, Theolair, Theosol);
• birth control pills or hormone replacement therapy;
• an antibiotic, or drugs to treat tuberculosis;
• antifungal medication such as fluconazole (Diflucan) or ketoconazole (Nizoral);
• a blood thinner such as warfarin (Coumadin, Jantoven);
• cancer medicines;
• heart or blood pressure medication;
• HIV or AIDS medications;
• medication to treat depression or mental illness, such as lithium (Eskalith, Lithobid);
• medicines to prevent organ transplant rejection;
• other seizure medications, such as valproic acid (Depakene, Stavzor);
• steroid medication; or
• thyroid replacement medication.

This list is not complete and there are many other drugs that can interact with carbamazepine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.

Where can I get more information? Back to top

Your pharmacist can provide more information about carbamazepine.